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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by DebbieLynn on August 17, 2001, at 12:28:15
Hello,
I have been a reader of this board for a couple of months now. I started Effexor XR in April of this year. I started out at 37.5mg and titrated up to 225mg, where I have been about 2 1/2 months. I am also on 100mg of Wellbutrin SR to augment sexual side effects of the Effexor (which does work)Anyway..Once I got up to the 225mg level (it took about 4 weeks to work) I felt great! But for some reason (recently) I feel depression lurking in the shadows. I am tired most of the time, do not have much interest in doing anything. I went to my pdoc and told him how I was feeling, and he suggested we up the dosage to 300mg. I normally take 150mg in the am and 75 mg in the pm. So yesterday I took my usual 150mg in the am and 75mg plus 37.5mg. I decided to make the increase slowly instead of just increasing right up to 300mg.
Is it normal to have to increase a dose that you have become accustomed to? I had a H*** of a time getting through the side effects starting on this medication. I am just wondering if this has happened to anymone else. My moods a stabilized, its just the "blah" feeling day in and day out. I am tired all of time, and( Effexor and Wellbutrin are both activating meds.) All I want to do is sit on the couch and do absolutely nothing.
I am going to increase, but I am wondering what chemicals does this does have effects on, and if 75 more milligrams will make that much of a difference.
Sorry for the book!
Thank You!
Debbie
Posted by stjames on August 17, 2001, at 16:38:06
In reply to Increasing dosage of Effexor XR * Scared*(Cam), posted by DebbieLynn on August 17, 2001, at 12:28:15
This difference between 225 mgs and 300 mgs Effexor with the difference between night and day for me.
So, do you want to do nothing, and suffer, or try something and perhaps get better ?
James
Posted by Cam W. on August 17, 2001, at 17:21:59
In reply to Increasing dosage of Effexor XR * Scared*(Cam), posted by DebbieLynn on August 17, 2001, at 12:28:15
James - Sometimes, you are too funny; blunt... but funny!;^P
Debbie - Unlike other with antidepressants (eg. SSRIs peak at a certain dose; TCAs may become toxic), as you increase the dose of Effexor XR, you seem to get more antidepressant activity. It is at the 225mg to 300mg level when the blocking of the norepinephrine transporter complex kicks in (eg. some people say they feel it at 150mg). This dose may change the dynamics of the antidepressant effect, usually for the good.
An increase in dosage to 300mg daily may be warranted. Many people take 300mg of Effexor XR daily; usually in one dose (ie 2 x 150mg caps in the morning). Side effects may return with every increase in dosage with Effexor, but they never seem to be as horrible as the initial couple of weeks.
Unless you are a fast metabolizer of Effexor, once daily dosing is fine. You can stick to the twice daily dosing if side effects (esp. start-up side effects) are a problem.
Be sure to remember to wean off ot the Effexor XR slowly, if your doc and you ever decide to have you stop it.
Oh, BTW, an increase of 75mg of Effexor XR to 300mg is sort of a high-middlin' dose, or a low-high dose (How about them scientific terms...I'm blanking right now). Just work your way through those blah days, and hopefully you will find an effective dose, for you. I have heard of docs using 600mg, and one case of 750mg, of Effexor in hospital inpatients, who were severely depressed. I haven't personally of outpatient doses climbing much higher than 375mg.
I hope that this is of some help. - Cam
Posted by afatchic on August 18, 2001, at 8:53:08
In reply to Re: Increasing dosage of Effexor XR * Scared*(Cam) » DebbieLynn, posted by Cam W. on August 17, 2001, at 17:21:59
Thank you all for your thoughtful and informative responses. This is the same question that I've had and I feel much better about increasing my Effexor dose now.
> James - Sometimes, you are too funny; blunt... but funny!;^P
>
> Debbie - Unlike other with antidepressants (eg. SSRIs peak at a certain dose; TCAs may become toxic), as you increase the dose of Effexor XR, you seem to get more antidepressant activity. It is at the 225mg to 300mg level when the blocking of the norepinephrine transporter complex kicks in (eg. some people say they feel it at 150mg). This dose may change the dynamics of the antidepressant effect, usually for the good.
>
> An increase in dosage to 300mg daily may be warranted. Many people take 300mg of Effexor XR daily; usually in one dose (ie 2 x 150mg caps in the morning). Side effects may return with every increase in dosage with Effexor, but they never seem to be as horrible as the initial couple of weeks.
>
> Unless you are a fast metabolizer of Effexor, once daily dosing is fine. You can stick to the twice daily dosing if side effects (esp. start-up side effects) are a problem.
>
> Be sure to remember to wean off ot the Effexor XR slowly, if your doc and you ever decide to have you stop it.
>
> Oh, BTW, an increase of 75mg of Effexor XR to 300mg is sort of a high-middlin' dose, or a low-high dose (How about them scientific terms...I'm blanking right now). Just work your way through those blah days, and hopefully you will find an effective dose, for you. I have heard of docs using 600mg, and one case of 750mg, of Effexor in hospital inpatients, who were severely depressed. I haven't personally of outpatient doses climbing much higher than 375mg.
>
> I hope that this is of some help. - Cam
Posted by DebbieLynn on August 18, 2001, at 11:44:19
In reply to Re: Increasing dosage of Effexor XR * Scared*(Cam) » DebbieLynn, posted by Cam W. on August 17, 2001, at 17:21:59
> James - Sometimes, you are too funny; blunt... but funny!;^P
>
> Debbie - Unlike other with antidepressants (eg. SSRIs peak at a certain dose; TCAs may become toxic), as you increase the dose of Effexor XR, you seem to get more antidepressant activity. It is at the 225mg to 300mg level when the blocking of the norepinephrine transporter complex kicks in (eg. some people say they feel it at 150mg). This dose may change the dynamics of the antidepressant effect, usually for the good.
>
> An increase in dosage to 300mg daily may be warranted. Many people take 300mg of Effexor XR daily; usually in one dose (ie 2 x 150mg caps in the morning). Side effects may return with every increase in dosage with Effexor, but they never seem to be as horrible as the initial couple of weeks.
>
> Unless you are a fast metabolizer of Effexor, once daily dosing is fine. You can stick to the twice daily dosing if side effects (esp. start-up side effects) are a problem.
>
> Be sure to remember to wean off ot the Effexor XR slowly, if your doc and you ever decide to have you stop it.
>
> Oh, BTW, an increase of 75mg of Effexor XR to 300mg is sort of a high-middlin' dose, or a low-high dose (How about them scientific terms...I'm blanking right now). Just work your way through those blah days, and hopefully you will find an effective dose, for you. I have heard of docs using 600mg, and one case of 750mg, of Effexor in hospital inpatients, who were severely depressed. I haven't personally of outpatient doses climbing much higher than 375mg.
>
> I hope that this is of some help. - Cam
Thanks for all of the information. You guys seem to know quite a bit about Effexor, thats why I asked. 2 days ago I increased the dose by 37.5mg and probably in 2-3 more days I'll go to 300mg. I just thought it was strange that 225mg worked very well for awhile and then all of sudden did not work as well. Would the Wellbutrin have any effect on this? I just hope the 300mg dose doesn't "poop out" on me. Effexor has made me feel so much better!Thanks again
Debbie
Posted by DebbieLynn on August 18, 2001, at 11:47:29
In reply to Re: Increasing dosage of Effexor XR * Scared*(Cam), posted by stjames on August 17, 2001, at 16:38:06
> This difference between 225 mgs and 300 mgs Effexor with the difference between night and day for me.
>
> So, do you want to do nothing, and suffer, or try something and perhaps get better ?
>
> JamesJames...
Yes I do want to feel better. I just wanted some opinions on how much different 300mg would be from 225. Did you just go right up to 300 or did you play with your dose?? How long have you been on Effexor? I just want the same results I first experienced at 225mg, and I dont want them to go away.Debbie
Posted by stjames on August 18, 2001, at 16:15:11
In reply to Re: Increasing dosage of Effexor XR *stjames, posted by DebbieLynn on August 18, 2001, at 11:47:29
> James...
> Yes I do want to feel better. I just wanted some opinions on how much different 300mg would be from 225. Did you just go right up to 300 or did you play with your dose?? How long have you been on Effexor? I just want the same results I first experienced at 225mg, and I dont want them to go away.
>
> DebbieI have been on Effexor since 1995. I dont have the horrabile side effects many have with Effexor
except the sweating. Every dose increase causes me to sweat for a few days, so for me I just go right to the new dose, and get it over with. I do not reccomend this to others, though. I was stable at a lower dose for the first years, then found I needed 300 mgs to pull me out of a depression. My doc and I played around with going from 150 to 300 and found the depression returned
if I took less then 300 mgs.james
This is the end of the thread.
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